Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Dec 9;16(12):e75380.
doi: 10.7759/cureus.75380. eCollection 2024 Dec.

Clinical Characteristics and Prevalence of Atrial High-Rate Episodes in Patients With Cardiac Implantable Electronic Devices

Surachat Jaroonpipatkul  1 , Thipsukhon Sathapanasiri  2 , Chananan Maliang  1 , Apichai Pokawattana  1 , Leenhapong Navaravong  3
Affiliations

Clinical Characteristics and Prevalence of Atrial High-Rate Episodes in Patients With Cardiac Implantable Electronic Devices

Surachat Jaroonpipatkul et al. Cureus. .

Abstract

Background Atrial high-rate episodes (AHREs) detected by cardiac implantable electronic devices (CIEDs) are indicative of future clinical atrial fibrillation (AF) and stroke risk. This study aimed to investigate the prevalence of AHREs among Thai patients with CIED implantation and identify associated risk factors. Methods A retrospective observational study enrolled 278 CIED patients with AHREs lasting five minutes to 24 hours, with an average atrial rate ≥ 175 bpm, excluding known clinical AF at device implantation. Data were collected from electronic and paper medical records, and statistical analyses included Student's t-test, Mann-Whitney U test, and multivariable logistic regression. Results Of the 278 patients, 52 with pre-existing AF diagnoses were excluded. The median age was 64.86 years, with a balanced gender distribution. Hypertension was observed in 121 (53.54%) patients and diabetes in 62 (27.43%) patients. Following the designated follow-up period, 58 (20.79%) patients experienced AHREs, and eight (3.53%) developed clinical AF. Multivariable analysis confirmed diabetes as a significant risk factor for AHREs. Conclusion This study underscores the importance of monitoring AHREs for early detection of AF and stroke risk in Thai patients with CIEDs. Diabetes emerged as a significant risk factor, highlighting the need for personalized management strategies in clinical practice.

Keywords: atrial fibrillation; atrial high-rate episodes; cardiac implantable electronic device (cied); heart arrhythmia; thailand.

PubMed Disclaimer

Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Research Ethics Committee Rajavithi Hospital issued approval 64210. The study protocol was approved by the local Institutional Review Board/Ethics Committee and adhered to the principles of the Declaration of Helsinki. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

References

    1. Additive role of plasma von Willebrand factor levels to clinical factors for risk stratification of patients with atrial fibrillation. Lip GY, Lane D, Van Walraven C, Hart RG. Stroke. 2006;37:2294–2300. - PubMed
    1. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the Euro Heart Survey on Atrial Fibrillation. Lip GY, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ. Chest. 2010;137:263–272. - PubMed
    1. Association between antithrombotic treatment and outcomes at 1-year follow-up in patients with atrial fibrillation: the EORP-AF General Long-Term Registry. Boriani G, Proietti M, Laroche C, et al. Europace. 2019;21:1013–1022. - PubMed
    1. Asymptomatic atrial fibrillation in pacemaker recipients: incidence, progression, and determinants based on the atrial high rate trial. Orlov MV, Ghali JK, Araghi-Niknam M, Sherfesee L, Sahr D, Hettrick DA. Pacing Clin Electrophysiol. 2007;30:404–411. - PubMed
    1. 2016 ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Kirchhof P, Benussi S, Kotecha D, et al. https://pubmed.ncbi.nlm.nih.gov/27567408/ Eur Heart J. 2016;37:2893–2962. - PubMed

LinkOut - more resources